We don’t know why a child develops asthma or how to prevent the onset of disease but we know enough to do better in managing the symptoms of asthma and the adverse health outcomes that some children experience. Interventions to support the reduction of environmental exposures and facilitate access to care and asthma self-management have been rigorously evaluated and well documented.
The following is a summary of some of the seminal studies in childhood asthma that have implications for the asthma management programs of today.
The Inner-City Asthma Studies
The National Cooperative Inner-City Asthma Study (NCICAS) Phase I: A series of studies culminating in a well-defined and effective Asthma Counselor Intervention which was tailored to the specific risks faced by the families and children with asthma.
The National Cooperative Inner-City Asthma Study (NCICAS) Phase II: To address the unique combination of risk factors that existed in urban minority populations, a comprehensive computerized risk assessment tool called the CARAT (Child Asthma Risk Assessment Tool) was designed to assess each of the risk domains identified in NCICAS Phase I.
Inner-City Asthma Study (ICAS): Initiated in part due to the compelling evidence regarding the pervasive environmental exposures and sensitivities among the NCICAS children, this study used trained Environmental Counselors, who assisted families in remediating exposures in their homes based on the child's allergic profile and sensitivities.
RAND Studies and NIH Asthma Outcomes Workshop: MCAN's commissioned study by the RAND Corporation revealed the need for asthma research using standard definitions and outcomes to allow comparison across studies and aggregation of data. The NIH Asthma Outcomes Workshop was the consensus process that led to the proposed standardized outcomes for clinical research in asthma.
Head-off Environmental Asthma in Louisiana: HEAL was a collaborative research project to learn more about the effects of mold and other indoor allergens on children with asthma in post-Katrina New Orleans, and to implement evidence-based case management and mitigation of triggers in the home. The project was conducted by the Tulane University Health Sciences Center and the New Orleans Department of Health with funding from National Institute of Environmental Health Sciences (NIEHS) and the National Center for Minority Health and Health Disparities (NCMHD) of the NIH, the deLaski Family Foundation, and MCAN.
The Community Guide
The Community Preventive Services Task Force is a is an independent, nonfederal, unpaid panel of public health and prevention experts that provides evidence-based findings and recommendations about community preventive services, programs, and policies to improve health, entitled The Community Guide. The Centers for Disease Control and Prevention provides administrative, research, and technical support for the Community Preventive Services Task Force.
In 2011, the Task Force conducted a systemic scientific review to evaluate the evidence on effectiveness of home-based, multi-trigger, multicomponent interventions with an environmental focus to improve asthma-related morbidity outcomes. It found that these interventions improved overall quality of life for children with asthma and were cost effective.
Allies Against Asthma
Allies Against Asthma was a national initiative to improve asthma control for children and adolescents. Funded by the Robert Wood Johnson Foundation with direction and technical assistance provided by the Center for Managing Chronic Disease, University of Michigan, Allies supported seven community-based coalitions and their efforts to improve the way asthma is managed in their communities and provides resources and tools to support other asthma coalitions and programs throughout the United States. Learn more about Allies Against Asthma's processes and outcomes in the article "Community Coalitions to Control Chronic Disease: Allies Against Asthma as a Model and Case Study," published in a supplement to Health Promotion Practice.
CDC Controlling Asthma in American Cities Project
The CDC's Controlling Asthma in American Cities Project (CAACP) provided funding to seven inner-city sites to support the translation of scientific advances in the treatment of asthma into, comprehensive programs to improve asthma control among children in underserved communities.
The findings are included in the publication, "It Takes a Community: Controlling Asthma in American Cities" published in the Journal of Urban Health.